Bad Breath No. 1 Complaint

The majority (75%) thought they had bad breath, and 65% believed their sweat smelled bad. About 30% blamed flatulence or feces for their foul smell, and 20% blamed their urine.

"Most were preoccupied with three different smells on average," Phillips says.

To mask their perceived odors, 90% turned to perfume or powders. "One person even swallowed perfume to improve her breath," Phillips says.

About 70% resorted to frequent showers, 60% constantly chewed gum, and 50% sucked on mints. About a quarter changed their clothes several times a day to get rid of the imaginary stench.

"Some of these patients would use an entire bar of soap in one shower," she says.

Two-Thirds Think About Suicide

The condition affected their entire life, she says. A total of 74% said they avoided social situations, and 40% stayed in for at least a week because they were so embarrassed by their problem.

More problematic, Phillips says, is that 68% had suicidal thoughts and 32% actually attempted killing themselves. About half had been hospitalized for a psychiatric problem.

If someone thinks they suffer from the condition, they should seek psychiatric help, she says.

"We're not clear what treatment is best, but selective serotonin reuptake inhibitors (SSRIs) may be helpful," she says.

SSRIs work by blocking a receptor in the brain that absorbs a chemical called serotonin that is known to influence mood. They're commonly used to treat depression and other mood disorders.

Phillips says olfactory refractory syndrome is not an actual diagnosis in the current version of DSM-IV, the bible of psychiatry, although it is mentioned under the heading of psychoses.

For the new version of DSM-V, which is expected by 2013, doctors want to add an appendix of disorders for which further research is needed, so "we can have an agreed-upon definition," Phillips says.

There are no good figures on how common the condition is, but one Japanese study showed that more than 2% of college students were concerned about having strange body odors.

"But we can't assume that translates to olfactory reference syndrome," she says.

Jeffrey Borenstein, MD, chairman of the APA's communication council and medical director of Holliswood Hospital in Queens, N.Y., tells WebMD he never heard of the condition until Phillips presented her research.

"It sounds very debilitating; we need a lot more research," says Borenstein, who moderated the news briefing.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

SOURCES: 163rd Annual Meeting of the American Psychiatric Association, New Orleans, May 22-26, 2010.